Saturday, 1 February 2014

Who's counting?

So I decided it was just too hard to organise an international move in a hurry ahead of starting treatment. The lovely people at the Peter MacCallum centre talked to my people in Hamilton, and I got an email to say I was booked in for another biopsy in NZ on the Monday after I got back. That was another day surgery experience. Margaret came to pick me up from the recovery room and spoiled me as usual. This time it took only a week to get results. I saw the registrar, a different one this time, who had done the surgery. He said he'd taken quite a bit out, so that explained why I'd been given morphine at the hospital. He didn't think it had been at all obvious to the eye, so it is interesting that the Melbourne guys were so convinced just by looking. Yes, biopsy result was consistent with squamous cell carcinoma. That is a good thing, because it allows the chemoradiation guys to plan a targeted approach that will be much less damaging in the long term.

Treatment has been delayed a week and is now due to start on 10 Feb. They have booked me into the Cancer Lodge in Hamilton for the 7 weeks of daily radiation. I'll have radiation 5 days a week. It only takes 10 minutes or so each day. I'll be having some chemo at the same time, not sure what or when. I'll stay at the Lodge Mon to Fri and there is a shuttle bus to Rotorua.

Meantime I have learned a bit about how to make sense of cancer statistics from reading a beautifully-written and compelling book by Siddhartha Mukeherjee - The emperor of all maladies: a biography of cancer. He won the Pulitzer Prize for Non-Fiction for this book, written in his spare time between being a dad, a doctor and a researcher.

There are more people than ever getting cancer. But part of that is because we are living longer, and the chances of anyone getting a cancer diagnosis increase quite dramatically with age. The overall survival rates are improving, but only slowly, and the overall success rate is driven by improvements in treatment in a couple of areas.

People diagnosed with breast, bowel and ovarian cancers and non-Hodgkin's lymphoma are now twice as likely to survive for at least 10 years compared to those diagnosed in the 1970s. (UK Cancer Research).

Yes, treatment has improved for these, but earlier diagnosis and better screening programmes help significantly to account for the apparent success. Still, one in 4 deaths in the US is due to cancer, and across the whole lifetime 1 in 2 men and 1 in 3 women will receive a cancer diagnosis. In Australia, cancer is the leading cause of total burden of disease. Across Australia, 4,000 people this year will get a diagnosis similar to mine (though 3,000 of those will be males).

For 2006–2010, five-year relative survival for all cancers combined in Australia was 66.1 per cent...Relative survival rates for cancer have increased in recent years (Cancer Australia)

That one is presented to sound good - well, we are winning aren't we? Or are we? Read it again. Only 66% of people who are found to have cancer are going to be alive five years following the diagnosis. Is that good? Good enough?

One of the quotes I read today said something along the lines of -- treatment for cancer is like whacking a dog with a stick to get rid of fleas.

I had an MRI last week in Hamilton.

How an MRI works is another story, but having an MRI scan is a pretty weird experience. It takes quite a long time and the machine is very noisy. Very Jetsons-noisy actually. For something so high-tech it sounds very retro space-age, grinding and pulsating and clanking away, completely drowning out the (ghastly) music of Coast radio coming through the headphones they provided.

I can't help but think that cancer treatment today, for all this state of the art technology, has not greatly improved over where it was in the days when all they could do was cut out the obvious tumours and hope they'd got it all. Chemotherapy itself can sometimes cause similar mutations as happen with HPV, resulting in even-more rampant and aggressive forms of cancer, and so can radiotherapy. Still, if it is all there is to get of my fleas, I might as well submit to the stick.